Amlodipine + Atenolol: Uses,Dosage,Side Effects

Generic Name
Amlodipine + Atenolol

(Cardiovascular Preparations)
Combined antihypertensive preparations

Pharmacology :
Amlodipine may be a dihydropyridine calcium antagonist that inhibits the transmembrane influx of calcium ions into vascular smooth muscle and heart muscle; it's a greater effect on vascular muscle than on cardiac muscle. Amlodipine may be a peripheral vasodilator that acts directly on vascular smooth muscle to cause a discount in peripheral vascular resistance and reduction in vital signs. Amlodipine reduces tone, decreases coronary vasoreactivity, and lowers cardiac demand by reducing afterload.

Atenolol may be a cardioselective beta-adrenergic blocker. The cardio selectivity is dose-related. Atenolol causes a discount in vital signs by lowering flow, decreasing the plasma renin activity, and sympathetic outflow from CNS. Atenolol also causes a discount in myocardial oxygen demand by virtue of its negative inotropic and negative chronotropic effects.

Indications :
Amlodipine & Atenolol is indicated in:
  • Hypertension not controlled by monotherapy
  • Angina pectoris & hypertension co-existing diseases
  • Post MI patients
  • Refractory angina where nitrate therapy has failed
Dosage & Administration :
The recommended dosage is one tablet daily of (Amlodipine 5 mg & Atenolol 50 mg) or (Amlodipine 5 mg & Atenolol 25 mg). Depending upon the therapeutic response, titration of the dosage is suggested. In elderly patients, it's advisable to initiate the therapy with ½ tablet of a fixed-dose combination of Amlodipine & Atenolol (i.e. 2.5 mg of Amlodipine & 25 mg Atenolol).

Interaction :
Amlodipine has been safely administered with thiazide diuretics, beta-blockers, alpha-blockers, angiotensin-converting enzyme inhibitors, long-acting nitrates, sublingual nitroglycerin, non-steroidal anti-inflammatory agents, antibiotics, and oral hypoglycemic agents. In vitro data from studies with human plasma indicate that amlodipine has no effect on protein binding of the drugs tested (Digoxin, Phenytoin, Warfarin, or Indomethacin).

Atenolol reduces the clearance of Disopyramide by 20%. Additive negative inotropic effects on the guts could also be produced. At doses of 1 gm and above, Ampicillin may reduce Atenolol levels. Beta-blockers may decrease tissue sensitivity to Insulin and inhibit Insulin secretion, e.g. in response to oral antidiabetics. Atenolol has less potential for these actions.

Contraindications :
Hypersensitivity to either component, sinus bradycardia, second and better degrees of Adams-Stokes syndrome, shock, hypotension, congestive coronary failure, poor left ventricular function.

Side Effects :
The combination of Amlodipine and Atenolol is well tolerated. Overall side effects include fatigue, headache, edema, nausea, drowsiness, anxiety, and depression.

Pregnancy & Lactation :
Atenolol crosses the placenta. So it's contraindicated in pregnancy. It should be avoided during lactation.

Precautions & Warnings :
Atenolol may mask the symptoms of hyperthyroidism. it's going to also mask the symptoms of hypoglycemia, also as enhance the consequences of hypoglycaemic agents in patients with DM.

Storage  :
Store in a cool dry place shielded from light. exclude of reach of children.

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